September 12, 2023 • 4 min read
Posted Sep. 12, 2023
Insurance companies are in the business of making money, and they will do whatever it takes to avoid paying out claims. Fighting insurance claim denials can be frustrating and even devastating for people who have been injured in accidents and need financial compensation.
In this article, we will expose some of the big insurance tactics that are used to deny claims. We will also provide tips on how to fight back and get compensated.
Here are some of the most common tactics that insurance companies use to deny claims:
- Asking for unnecessary paperwork: Insurance companies will often ask for unnecessary paperwork in an attempt to delay the claims process and make it more difficult for the policyholder to get the compensation they deserve. This paperwork could include medical records, police reports, and witness statements.
- Denying coverage for pre-existing conditions: Insurance companies will often deny coverage for claims that are related to pre-existing conditions. This is even if the policyholder has been paying premiums for years.
- Blaming the policyholder for the accident: Insurance companies will often try to blame the policyholder for the accident in order to deny the claim. This could include arguing that the policyholder was not careful enough or that they were driving too fast.
- Underestimating the severity of the injuries: Insurance companies will often underestimate the severity of the policyholder’s injuries in order to reduce the amount of compensation they have to pay. This could include arguing that the policyholder’s injuries are not permanent or that they are not as serious as they claim.
Some other sneaky tactics that insurers use to deny claims may include:
- Trying to get you to settle as quickly as possible. The faster they can get you to agree to settle, the less they may have to pay out. In Texas, the statute of limitations is two years, so the insurers know that if they don’t settle quickly, you’ll have up to two years to claim thousands of dollars, or more, in medical expenses and other bills for years to come.
- Being way too nice. This is an attempt to get you to lower your guard, hoping you’ll reveal more details in your recorded conversations that they will later use against you.
- Lying to you. Yes, insurance companies can lie to you. One common thing they may say is, “You’ll get less money if you hire an attorney.” In most cases, you’ll still make more money than you would have going against the insurance company by yourself.
- Asking to see all of your medical records. Don’t do it! They want to find something in your medical records that they can use to deny your claim (like “pre-existing conditions”).
- Secretly watch you. Creepy, huh? Insurers will often hire private investigators to spy on you (in real life and even on social media) and try to get pictures or video of you to disprove your claim. It’s important to be honest about your injuries but at the same time, don’t push yourself to get better too quickly. Insurance companies will try to look for any evidence of “insurance fraud.”
- They’ll take their sweet time. Sometimes, insurance companies may tell you that they’ll get back to you about your claim, only to take weeks or months to update you on anything. They want to see how far they can push you. So don’t get impatient, keep contacting them, and don’t be afraid to get updates on your claim.
These tactics can have a devastating impact on people’s lives. They can prevent people from getting the medical care they need, force them to go into debt, and even lead to bankruptcy.
Here are some tips on how to fight insurance claim denials:
- Be prepared: Before you file a claim, gather all of the relevant paperwork, such as medical records, police reports, and witness statements. This will make it easier for you to fight the denial if it happens.
- Be persistent: If your claim is denied, don’t give up. Keep fighting for the compensation you deserve. You may need to hire an attorney or appeal the denial to the insurance company.
- Know your rights: Be familiar with your rights as a policyholder. This will help you understand what you can do if your claim is denied.
- Speak out: If you have been denied an insurance claim, speak out about it. This will help to raise awareness of the problem and put pressure on insurance companies to change their practices.
Conclusion
If your insurance claim has been denied, there are steps you can take to fight back. These steps include:
- Hiring an attorney: An attorney can help you understand your rights and fight for the compensation you deserve.
- Filing an appeal: You can appeal the denial of your claim to the insurance company.
- Contacting the state insurance commissioner: The state insurance commissioner can investigate your claim and take action against the insurance company if they have violated the law.
It is important to speak out against insurance claim denials. By doing so, you can help to protect other people from being taken advantage of.
Jim Adler & Associates Can Help.
If you’ve been in an accident and have suffered injuries, don’t wait to speak with an attorney. That’s what the insurance companies want you to do! For over 50 years, our law firm has been fighting insurance claim denials for Texans against big, greedy insurance companies. Contact us today for your free consultation.
